From city blocks to country roads, everyone deserves reliable, connected care. However, rural communities often face unique hurdles—from provider shortages to geographic isolation and facilities closures.
The Rural Health Transformation (RHT) Program, introduced in mid-2025, seeks to resolve many of the challenges by fundamentally changing how healthcare is delivered in rural areas. As states and health systems prepare to implement strategies for the RHT Program, the focus is shifting toward sustainable, community-rooted care models that incorporate technology and workforce development.
Given the AI-powered care navigation platform that connects community providers with traditional healthcare and network of thousands of tech-enabled community health workers, Pear Suite is already partnering with states to build community-based strategies into their implementation plan.
What is the Rural Health Transformation Program?
The RHT program aims to improve healthcare access, quality, and outcomes, and transform how healthcare is delivered in rural communities.
As part of the program, Rural Health Transformation funds totaling $50 billion will be distributed to states with approved plans over five years.
The projects, which were selected from proposals, will focus on key strategic areas aimed at innovation and health improvement, including:
- Make rural America healthy again
- Sustainable access
- Workforce development
- Innovative care
- Tech innovation
While the focus is on new ideas and innovation, states don’t have to look far to find evidence-based programs and approaches that work well for the most vulnerable populations. Community health workers have a long history of resolving rural health disparities, and now they have a tool designed to support the work they do, allowing them to connect to traditional care systems, successfully demonstrate impact, and improve patient engagement and value-based care metrics.
States are prepared to make dramatic changes; Pear Suite keeps them from guessing where to start.
How does Pear Suite support Rural Health Transformation plans?
Pear Suite has seen firsthand how technology-enabled community care can stabilize and strengthen rural systems.
- In rural Kansas, we helped standup a hub of community-based organizations working together to help seniors age in place.
- In rural Alaska, Pear Suite’s become the infrastructure for prominent CHWs to partner with local hospitals and collaborate on patient education.
- In rural California, the platform helped bring a community-based organization providing care coordination, systems navigation, and transportation support for cancer patients back from the brink of closure, restoring operations and enabling long-term sustainability.
Together, a modern care navigation platform and a supported CHW workforce directly advance states’ RHT strategies in four critical ways.
1. Advancing Prevention and Chronic Disease Management at Scale
RHT Program funds may be used to promote evidence-based, measurable interventions for prevention and chronic disease management, an area where CHWs thrive, particularly in rural settings with limited primary care access.
Pear Suite enables CHWs to deliver care through consistent, proactive outreach supported by customizable care pathways, goal templates, technology-driven engagement tools, and education in 243 languages. The platform also supports automated follow-ups via text and email, ensuring that preventive screenings, chronic condition check-ins, and appointments are completed, while structured workflows ensure interventions are documented and measurable. These efforts alone drive a $2.47 return for every $1 invested by reducing hospitalizations and achieving a 30% or more boost in care gap closure.
2. Strengthening Community-Based Referrals and Behavioral Health Access
CMS is highlighting the importance of innovative changes across the healthcare ecosystem that will enable states to enhance access in rural communities. These changes are focused on improving the access, quality, and outcomes of healthcare services. A major challenge currently faced in many rural areas is the manual management of referrals, which often results in duplicated efforts, delays, and fragmented care.
In partnership with Social Health Access Referral Platforms (SHARPs), community services directories, and referral tools, Pear Suite boosts referral coordination with AI-powered, closed-loop communication, health education, and navigation. CHWs and navigators can identify and promote behavioral health, maternal health, opioid use disorder treatment, and basic needs; assign tasks within care plans; and track completion in real time. This improves continuity across providers and ensures rural residents actually receive the services they’re referred to—an essential component of right-sizing and strengthening rural care delivery systems.
3. Supporting Sustainable Payment and Value-Based Care Models
For rural transformation to last, CMS emphasizes the need for innovative models of care, including value-based arrangements and alternative payment models. Community-based services must be financially sustainable to remain part of the rural health infrastructure.
Pear Suite supports approved RHT uses of funds related to provider payments and technology-enabled reimbursement by offering claims management, billing, credentialing, contracting, clinical review, and compliance support. We help CBOs, CHWs, and doula organizations generate and submit claims aligned with Medicaid benefits in states where it’s available and handle the operational aspects of personnel management and care delivery, enabling states and providers to move beyond short-term grant funding and toward sustainable, performance-driven reimbursement and infrastructure. These are critical for retaining workforce talent and ensuring community-based care remains viable in rural markets.
4. Modernizing Data, Reporting, and Technology Infrastructure
RHT Program funds may also be used for technical assistance, software, and hardware that improve efficiency, cybersecurity, and patient outcomes. Data modernization is foundational to this goal. And Pear Suite supports this goal with tools.
Pear Suite provides population-level dashboards that translate frontline community data into actionable insights aligned with CMS expectations. States and rural partners can track outcomes, monitor intervention performance and engagement, and demonstrate the impact of community-based interventions across prevention, chronic disease management, and behavioral health. This data-driven approach not only strengthens compliance and accountability but also supports long-term funding and system transformation. Since Pear Suite’s care navigation platform is interoperable with other electronic health records (EHRs) and is HIPAA, SOC 2, and HISTRUST compliant, health systems and hospitals can access important health information for their patients to improve their care when they do need care in a clinical setting.
We have already onboarded thousands of community-based providers from more than 300 organizations nationwide and impacted over 100,000 community members. From initial onboarding to CHW workforce development and recruitment and ongoing success consultations, we can help states deliver technology solutions within an existing CHW or community care program or support the deployment of a statewide, rural-friendly CHW workforce that delivers lasting impact. To ensure that Pear Suite is built into RHT plans, meet with a member of our growth team.
What is the role of community health workers and community-based organizations in addressing rural healthcare challenges?
Since 2013, more than 100 rural health facilities have closed due to financial strain and workforce shortages, leaving many communities without critical healthcare services. Nearly 20% of Americans live in rural areas, yet only about 9% of physicians practice there. This explains why two-thirds of all federally designated Primary Care Health Professional Shortage Areas (HPSAs) are in rural regions.
This leaves people to either travel or go without care. Already, many living in rural communities must travel an additional 20 to 40 miles for inpatient or specialty care. With recent closures and even more financial strain on the horizon, access to primary, urgent, or even emergency care may be at risk, further increasing the likelihood that rural residents choose to defer care, even though they experience disproportionately high rates of chronic conditions.
The Centers for Medicare and Medicaid Services’ (CMS) Rural Health Transformation (RHT) Program recognizes that improving rural health outcomes requires more than hospital stabilization alone.
The program prioritizes prevention, chronic disease management, behavioral health and substance misuse, workforce sustainability, and technology-enabled care models that strengthen the entire rural health ecosystem. Community-based organizations (CBOs), community health workers (CHWs), promotores, care navigators, and other community providers who operate closest to patients’ daily lives have long been effectively filling this gap. However, they have been traditionally undervalued and underecognized for their potential to positively impact population and community health.
With RHT, states and health systems are encouraged to fully embed CBOs and CHWs into the care delivery ecosystem as they’re best positioned to deliver evidence-based, measurable interventions in settings where access to care is often limited, fragmented, or delayed. They support prevention and chronic disease management, coordinate access to behavioral health and substance use disorder services, and address social drivers of health, such as food, housing, and transportation, that disproportionately impact rural communities. Making this change has never been easier. With solutions such as Pear Suite’s care navigation and billing platform and their CHW provider network, states, health plans, and health systems have ready access to trained and vetted CHWs and software that is built specifically to connect the community workforce to traditional healthcare.
Pear Suite is ready to support states with transformation and stabilization plans, particularly focusing on elevating the community workforce with the infrastructure to scale person-centered care. To learn more about how Pear Suite can help your state elevate your CHW programs with technology, schedule a consultation call with a member of our growth team.
